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Dose-adjusted EPOCH-R or R-CHOP-based immuno-chemotherapy with mediastinal radiotherapy are acceptable treatment options. We report a retrospective analysis of PMBL patients treated with high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) consolidation or dose-dense immuno-chemotherapy alone. A comparison of the two consolidation strategies showed no significant difference in 5-year PFS (95.5% vs. 82.4%, HR 0.22 95% CI 0.03\u20131.69,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.13) or OS (100% vs. 87.1%, HR 0.1 95% CI 0.006\u20131.69,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.11), with a trend toward better survival in the preplanned HDCT\/ASCT group. Notably, 35.3% of patients received additional HDCT\/ASCT after an inadequate response to dose-dense immuno-chemotherapy. When comparing all patients, with or without first-line HDCT\/ASCT consolidation, regardless of the initial consolidation strategy, we found a significant difference in 5-year PFS (96.2% vs. 75%, HR 0.09 95% CI 0.01\u20130.83,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.03) and OS (100% vs. 80.1%, HR 0.03 95% CI 0.002\u20130.7,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.03) for patients treated with HDCT\/ASCT. In addition, mediastinal radiotherapy was administered significantly less frequently in patients treated with HDCT\/ASCT. In conclusion, high-dose chemotherapy and autologous stem cell transplantation may be a valid strategy to induce a favorable long-term outcome and spare radiotherapy in patients with PMBL.\n                  <\/jats:p>","DOI":"10.1007\/s00277-026-07009-w","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T09:01:08Z","timestamp":1776416468000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary mediastinal B-cell lymphoma: upfront high-dose chemotherapy with autologous stem cell transplantation results in favorable long-term outcome and may spare radiotherapy"],"prefix":"10.1007","volume":"105","author":[{"given":"Tino","family":"Vollmer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Str\u00fc\u00dfmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Glatzki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konrad","family":"Aumann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Fritsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justus","family":"Duyster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Mertelsmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Finke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinhard","family":"Marks","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"7009_CR1","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1182\/blood-2016-01-643569","volume":"127","author":"SH Swerdlow","year":"2016","unstructured":"Swerdlow SH, Campo E, Pileri SA et al (2016) The 2016 revision of the World Health Organization classification of lymphoid neoplasms. 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